慎用大承气汤治疗机械性肠梗阻

Carefully Use of Dachengqi Decoction in Treating Mechanical Intestinal Obstruction

关键词:  大承气汤  辨证应用  阳明腑实  肠梗阻

Key words:  Dachengqi Decoction  differentiation of symptoms and signs and application  excess syndrome of YANG MING FU-organ  intestinal obstruction

摘要:

大承气汤出自《伤寒杂病论》,是张仲景为治疗阳明腑实证而立,在临床上大承气汤应用广泛。许多学者将大承气汤作为治疗肠梗阻的主方。张仲景在大承气汤证中言腹满痛,腹满而喘,腹中转矢气等;在小承气汤证中言“腹大满不通者,可与小承气汤”。以此为界定标准。这些说明了张仲景使用大承汤是非常慎重的。并非肠腑不通就用大承气汤。肠梗阻有虚、实之分,缓、急之别,程度之异,临床上机械性肠梗阻使用大承气汤疗效也不理想。因此在治疗上必须详审病因,知犯何逆,随证治之,不可一味攻之。

Abstract:

Dachengqi Decoction came from Treatise on Febrile and Complicated Diseases that aimed at treating excess syndrome of YANG MING FU-organ.Dachengqi Decoction was widely applied in the clinic and the head of all the formula.Many scholars considered that Da chengqi Decoction was the primary prescription in treating intestinal obstruction.But the extent of abdominal pain and distension was considered to be the basis of using Dachengqi Decoction or Xiao Chengqi Decoction.Therefore,the use of Dachengqi Decoction must be careful and the asthenia and sthenia,slow and urgent extent be distinguished.Dachengqi Decoction hadn’t perfect curative effect in treating mechanical intestinal obstruction.